Management

Management begins with accurate diagnosis of the organic possibilities, which should be ruled out with the appropriate investigation if necessary.

If a diagnosis of non-organic pain is reached, then the following points may be helpful in the management:

• reassurance that there is nothing serious going on to cause the pain; that there is nothing to find on examination
• gradual introduction of the idea that non-organic pain can occur, together with vigourous denial that this means the pain "Is all in his head"
• acknowledgement that the pain for the child is in fact very real
• further management involves clearer identification of trigger factors and ways to overcome them, methods to prevent reinforcement of pain when it occurs, and referal to psychology colleagues where appropriate.